Grandparents and Other Relatives Raising Children - Washington State ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
S P R I N G 2 0 1 8 • V O L U M E 1 1 . N O1 . E D I T I O N 3 0
Max Impact TBI Mobile
App Helps Empower
Your Patients
Page 27
Grandparents and Other
Relatives Raising Children
Page 24
OF FIC IAL PUBL ICATION O F
T H E WASHINGTON S TATE N URSIN G CAR E Q U A LI T Y A S S U R A N C E
C OM M ISSION AND THE WAS HIN GTON ST A T E D E P A R T ME N T
OF HEAL TH
2 washington NURSING COMMISSION NEWS
S P R I N G 2 0 1 8 • V O L U M E 1 1 . N O1 . E D I T I O N 3 0
PUBLISHED BY
Washington State Nursing Care Quality
Assurance Commission (NCQAC) The Washington Nursing Commission
P.O. Box 47864 News circulation includes over 100,000
Olympia, WA 98504 licensed nurses and student nurses in
Telephone 360-236-4703 Washington.
FAX 360-236-4738
DOH Pub 669-256
http://www.doh.wa.gov/hsqa/professions.
nursing/default.htm
COMMISSION MEMBERS 4
Message from the Chair. . . . . . . . . . . . . . . .
Tracey Rude, LPN
Chair Message from the Director. . . . . . . . . . . . . 6
Donna Poole, MSN, ARNP, PMHCNS-BC
Vice Chair Secretary of the Department of Health . ����� 8
Lois Hoell, MS, MBA, RN Meet the New Commission Members . . .10
Secretary-Treasurer
Gerianne Babbo, EdD, MN, RN Ring in the New Year by Earning
Mary Baroni, PhD, RN One Free CNE Contact Hour by
Adam Canary, LPN
Attending a HEALWA Webinar! . . . . . 12
Jeannie Eylar, MSN, RN Unbecoming a Nurse . . . . . . . . . . . . . . . . 14
Edie Marie Higby, Public Member
Being Part of the Solution: Preventing
Suellyn M. Masek, MSN, RN, CNOR
Opioid Overdose Deaths in Washington.. 16
Helen E. Myrick, MPA, BA, Public Member
Licensure Actions. . . . . . . . . . . . . . . . . . . 18
14
Sharon A. Ness, RN
Tiffany Randich, LPN
Nursing Assistants Fewer Complaints
Tracy Rude, LPN 20
Equal Lower Fees . . . . . . . . . . . . . . . . . .
Renee Ruiz, Public Member
Medical Marijuana Authorization Form. 21
Laurie Soine, PhD, ARNP
Yvonne M. Strader, MHA, BSN, BSPA, RN Exciting New Evidence Based
Resources Added to HEALWA. . . . . . . 22
Grandparents and Other Relatives
Raising Children . . . . . . . . . . . . . . . . . . . 24
Max Impact TBI Mobile App Helps
pcipublishing.com Empower Your Patients . . . . . . . . . . . . . 27
Created by Publishing Concepts, Inc.
28 24
David Brown, President • dbrown@pcipublishing.com Help Us Paint an Accurate Picture of
For Advertising info contact Washingtons Nursing Workforce. . . . . .
Michele Forinash • 1-800-561-4686
mforinash@pcipublishing.com
ThinkNurse.com
The Washington State Nursing Care Quality Assurance Information published in the Washington Nursing Advertisements contained herein are not endorsed by
Commission regulates the competency and quality of Commission News is copyrighted but may be repro- the Washington State Nursing Care Quality Assurance
licensed practical nurses, registered nurses and advanced duced for education and training purposes. The Nursing nor the Department of Health. The Washington State
registered nurse practitioners by establishing, monitoring Commission would appreciate credit for the material Nursing Care Quality Assurance Commission reserves
and enforcing qualifications for licensing, consistent stan- used. Direct Washington Nursing Commission News the right to accept or reject any and all advertisements
dards of practice, continuing competency mechanisms, questions or comments to: Editor, Nursing Care Quality in the publication. Responsibility for errors is limited to
discipline, and education. The commission establishes Assurance Commission, PO Box 47864, Olympia, WA corrections in a subsequent issue.
standards for approval and evaluation of nursing educa- 98504-7864 or mindy.schaffner@doh.wa.gov.
tion programs.
Executive Director
Paula R. Meyer, MSN, RN, FRE
The Department of Health is an equal opportunity agency. For persons with disabilities, this document is
Editor available on request in other formats. To submit a request, please call 1-800-525-0127 (TTY 1-800-833-6388).
Mindy Schaffner, PhD, MSN-CNS, RN For additional copies of this publication, call 1-800-521-0323. This and other publications are available at
http://www.doh.wa.gov/hsqa/.
washington NURSING COMMISSION NEWS 3
Message from the Chair
Tracy Rude, LPN, Health Sciences Career and Technical Education (HSCTE)
Chair, Nursing Care Quality Assurance Commission
Welcome to the January 2018 edition of the Nursing Care Quality Assurance Commission
(Nursing Commission) newsletter.
It is my pleasure and honor to serve as Nursing Commission chair. The trust given to me
by the commission to be in this position is humbling. I am just starting my second appointment
from Governor Inslee and know the next four years will pass far too quickly.
The Nursing Commission’s job is to protect the public and to enhance nursing practice. The
commission does this by enforcing regulations related to licensing, discipline, and education
for licensed practical nurses (LPN), registered nurses (RN), and advanced registered nurse
practitioners (ARNP). Because nursing remains the No. 1 most trusted profession, the commission
takes this responsibility seriously. It works toward maintaining public trust through subcommittee
work, and work with the National Council of State Boards of Nursing (NCSBN).
The Nursing Commission accomplishes its purpose by use of open public meeting
subcommittees. These committees work on important issues related to licensing and discipline
of nurses, standards of practice, and advanced practice standards, with participation from nurses
and others working in industry. These subcommittees are invaluable in advancing the work of
the commission. We encourage your participation. We post the date, time, agenda, and other
information on our website and listserv. Participants may also call the commission for information
at 360-236-4703. Staff members are always willing and able to help.
The Nursing Commission is a member of NCSBN, and is recognized for making significant
contributions to the mission and vision of NCSBN. Several commission and staff members
serve on committees within NCSBN, including serving on the NCSBN Board of Directors. The
commission actively participates in the Institute of Regulatory Excellence (IRE), discipline case
investigator training, National Council Licensure Examination (NCLEX) development, education,
and leadership succession planning. The commission continues its interest in the Enhanced Nurse
License Compact (ENLC) and the ARNP Compact.
I am proud to be part of this commission, and to do the work necessary to protect the public
and enhance nursing practice. This is an opportunity for which I am truly grateful. I look forward
to the work ahead with your involvement. We continue our work on criminal background checks
and Governor Inslee’s Opioid Task Force, where we have several commissioners and pro-tem
members participating in stakeholder meetings around Washington State.
4 washington NURSING COMMISSION NEWS
washington NURSING COMMISSION NEWS 5
Message from the Executive Director
By Paula R. Meyer, MSN, RN, FRE
Executive Director, Nursing Care Quality Assurance Commission
New Licensing Requirement
On January 1, 2018, all nurses with an active license in Washington
State must complete two surveys the Nursing Care Quality Assurance Commission (Nursing
Commission) requires for licensing. The Nursing Commission made this decision because in
Washington State we want to know the nurse’s educational preparation and areas of practice
to determine the need for nurses in particular areas of practice and locations.
In October of 2005, the Institute of Medicine https://fortress.wa.gov/doh/opinio/
recommended that 80 percent of registered nurses be s?s=WorkforceData. This survey needs to
prepared at the baccalaureate level. Historically, the be completed only one time, with your new
Nursing Commission had not collected information license. When you finish this survey, you
on the academic progression of nurses. To meet the will be re-directed to the Nursys® e-Notify
Institute of Medicine’s recommendation, we need a survey.
reliable collection of data. 2. New applicants use their new license number
Here are the steps to complete required licensing to register and complete their survey at
information: Nursys® e-Notify https https://www.nursys.
To renew your license, you must complete two com/EN/ENDefault.aspx.
surveys: We are all concerned about the security of
1. Nursing Commission Workforce survey: information being collected . At the Nursing
https://fortress.wa.gov/doh/opinio/ Commission, we rely on three levels of security to
s?s=WorkforceData assure the best data protection in today’s electronic
This survey needs to be completed only one world .
time, with your 2018 renewal. When you There are primarily four organizations working
complete this survey, you will be re-directed collaboratively to ensure the appropriate security
to the Nursys® e-Notify survey. controls are in place to protect nurses’ demographic
2. Register and complete your information at data: The Washington Center for Nursing (WCN),
Nursys® e-Notify: University of Washington (UW), Washington State
https://www.nursys.com/EN/ENDefault.aspx. Department of Health (DOH) and National Council
You must enter this survey as a nurse. Do of State Boards of Nursing (NCSBN) .
not enter the survey as an institution. Every The WCN and UW Center for Health Workforce
year when you renew your license, you Studies Registered Nurse Workforce Survey
must review and update your information as has been reviewed by Washington’s human
needed. subjects review board, like any other research
New applicants must complete the two surveys. study . The identities of individual nurses will be
The Nursing Commission issues the license when all kept confidential, no personal identifiers will be
requirements are satisfied. You will then complete disclosed, and all information will be reported in
the two surveys using your license number. aggregate form, consistent with all state and federal
1. New applicants must complete the regulations .
Nursing Commission Workforce survey The Department of Health (DOH), working
after receiving their license number: with Washington State Office of Cyber Security,
6 washington NURSING COMMISSION NEWS
works every day to detect, block and respond NCSBN has incorporated security policies,
to cyber-attacks on state networks. This work procedures and contractual security requirements
includes preventing and mitigating threats before that promote the protection of intellectual properties,
they can cause significant damage. Cyber threats employee and customer personal information, proper
will continue to evolve, and so will our defenses data security and data handling procedures, and data
against them. DOH and security partners protect the transmissions. NCSBN also performs assessments,
information entrusted to them and are also prepared audits, penetration tests, and vulnerability scans to
to respond in the event something unexpected help ensure NIST 800-53, moderate-impact security
occurs. control compliance.
The National Council of State Boards of Nursing The Nursing Commission already maintains
(NCSBN), Information Security Management personal and confidential information on nurses.
Program is aligned with the Security and Privacy The Nursing Commission will handle additional
Controls for Federal Information Systems and workforce information in the same manner as
Organizations. NCSBN uses the National Institute allowed under state and federal laws. Nursing
of Standards and Technologies (NIST) 800-53, workforce reports generated by use of this data
moderate-impact security controls framework for its will be reported in aggregate form. No personal
information security to protect the confidentiality, identifiers will be disclosed.
integrity and availability of information that I hope this information helps you understand why
NCSBN’s information systems process, store and the Nursing Commission passed this rule; how your
transmit. Please see the NIST website for additional personal information is protected; and, how to satisfy
information on the NIST 800-53 framework. the new licensing requirement.
YOUR NEXT STEP | UW TACOMA
Master of Nursing
- Nurse Educator
- Leader in Healthcare Delivery
Bachelor of Science in Nursing (RN to BSN)
ADN-BSN-MN Option
Our Graduates Say...
The class structure and schedule enabled me to work full time
I have deeper critical thinking skills with regard
to my patient care
I have tools to lead a team and strategically plan
for the future
I feel empowered to be a positive, active leader for change
Diversity is now better ingrained in how
I practice as a nurse
Call Now To Meet With An Advisor
On campus or invite us to your workplace!
www.tacoma.uw.edu/nursing
More info: 253.692.4470 | tnursing@uw.edu
washington NURSING COMMISSION NEWS 7
Secretary of the Department of Health
By John Weisman, DrPh, MPH
Dear Nurses of Washington State,
I hope you are all having a wonderful start to 2018! The year always starts off busy, busy, busy for
those of us engaged in state legislative affairs. As an even year, this is a “short” legislative session,
although short doesn’t necessarily mean it isn’t full. In fact, a short session often feels as if we have to
get more done in a shorter period of time.
While the winter in Olympia is certainly not without exciting and challenging days (and nights),
the product from our policy makers often affects our agency, our licensees, and our citizens. One major
bill that passed last year, Engrossed Substitute House Bill 1427 (ESHB 1427), requires the Nursing
Commission to work with four other licensing boards and commissions to write prescribing rules for
opioids. In addition, enhancements to the Prescription Monitoring Program (PMP) serve to address the
prescribing and diversion aspects of the opioid epidemic.
While not all nurses prescribe medications, nurses everywhere have a part in addressing this
significant problem in our communities. Whether you work in a community-based health clinic,
at a long-term care facility, or in acute care, you will probably be faced with treating and counseling
patients with opiate use disorder. As patient advocates, nurses are well-positioned to both help those
suffering from abuse and to educate on the risks of misusing prescription medication. As care providers
you have the opportunity to advocate, ensure and expedite use of the PMP to help keep patients safe,
and to ensure prescribing guidelines are followed. Prescribers of legend drugs can use the PMP and
can also delegate patient lookup to other licensed staff members, including RNs and LPNs. Find out
more on www.doh.wa.gov/pmp.
The opioid epidemic is being addressed collaboratively by partners across the state, but I encourage
you to become an active participant in addressing this growing problem. Participate in an ESHB 1427
workgroup meeting, and learn more about the epidemic from the Nursing Commission and other
continuing education opportunities. I also hope you begin conversations with your family, friends, and
fellow care providers. Proper use, safe storage, and disposal of prescription medication is knowledge
that is essential to keeping our communities healthy and safe.
For more information on safe storage and disposal please see www.lockyourmeds.org and
www.takebackyourmeds.org. As a valuable and trusted member of your community, you have a unique
opportunity to help explain to your patients, your friends, and your neighbors how this epidemic is
affecting all of us.
I hope you have a safe and healthy start to 2018.
8 washington NURSING COMMISSION NEWS
www.AcuteCareEd.com
Live Continuing Education
Local, Veteran, Nurse Owned Company - We Know What You Need!
Professional Conferences - Nurses Teaching Nurses
Skills Workshops - Interactive Class Size!
360-258-1838
7200 NE 41st Street • Ste. 206 • Vancouver, WA
Reach • Recruit
Retain WINTER 2016 •
VOLUME 9. N 3
O
. EDITION 24
W i n t e r 2 0 1 0 • V o l u m e 4 . n o1 . e d i t i o n 7
The Nature of
Recognizing Nursing Practice
and Treating the
S U M M E R 2 0 0 9 • V o l U M E 3 . N o2 . E d i t i o N 6
Breakdown s
Impaired Nurse:
Page 11
Fingerprint Cards for
Endorsement Applicants
Can Nurses Be
An Online
Page 12
Required to Washington Health Professional
Continuing ime? Services (WHPS): Recovery
Work OvertPage 17 That Saves Lives
Education
Page 14
Washington Center
for Nursing Update
Course Page 16
Page 14
Clinical Nurse
Specialist Survey
Page 15
Changing Times Promotes
Continued Focus on Patient Safety
Page 15
Patient Injury: It’s Not Just
the Physician Being Sued
Page 18
O f f i cial pu bl icatiO n O f Offic ial pub lic atiOn Of
t h e W a s h i n g t O n s tate nu rsin g c are Q u al ity the WashingtO n state nur sing c ar e Quality
a s s u r a n c e c O mmissiO n an d th e W ash in g tOn a ssur anc e c OmmissiOn and the WashingtO n
s t a t e d epartmen t O f h eal th state depar tme nt Of h e alth
OF
PUBLIC ATION CARE QUALI TY
OFFICI AL NURSI NG 1
WASHI NGTON NEWS
NGTON STATE AND THE G COMMISSION
THE WASHI COMMI SSION H on NURSIN
ASSUR ANCE TMENT OF
washingt
HEALT
STATE DEPAR
Reaching over 100,000
Washington Nurses
Washington Nursing
Commission News
to reserve advertising space
contact Michele Forinash
mforinash@pcipublishing.com
1-800-561-4686 ext.112
Our nursing journals reach over
2 million nurses, healthcare
professionals and educators
nationwide each quarter.
Arizona New Mexico
Arkansas North Carolina
The District North Dakota
of Columbia Ohio
Florida Oregon
Georgia South Carolina
Indiana South Dakota
Kentucky StuNurse/Nationwide
Mississippi Tennessee
Montana Washington
Nebraska West Virginia
Nevada Wyoming
ThinkNurse.com
washington NURSING COMMISSION NEWS 9
MEET THE NEW COMMISSION MEMBERS
Dr. Gerianne ensure our communities’ safety and wellbeing. As a
Babbo earned a member involved with Community-Minded Enterprises
diploma in nursing (CME) and Child Care Awareness Washington’s early
from St Vincent’s learning community, she will have a voice for our littlest
College of Nursing learners. This is just one of many awesome community
in Los Angles, Calif. partnerships that CME encourages and supports to make a
She was a member stronger, healthier, and happier community.
of the first cohort For more information about the Nursing
of RN-MN students Commission’s open public business forum and
at the University of Community-Minded Enterprises programs, see:
Washington earning http://www.doh.wa.govLicensesPermitsandCertificates/
her BSN and a MN NursingCommission
in advanced community health nursing with a specialty
in occupational health. Her doctorate is in educational http://community-minded.org/
leadership with an emphasis in nursing education from the
University of Washington, Tacoma. Sharon Ness,
Dr. Babbo is tenured faculty and the associate RN has been a staff
dean of nursing at Olympic College in Bremerton, nurse, primarily in
Washington. She taught and developed curricula in critical care, for 47
the associate degree and transition to associate degree years. She received
(TADN) nursing programs and the RN-BSN program. a diploma in nursing
Dr. Babbo led the development of the first RN-BSN and a degree in
program in the community college setting in Washington political science. She
State in 2007 and collaborated with the University continues to work per
of Washington Tacoma nursing program in a unique diem at the bedside.
partnership to promote nursing education progression in a She was recognized
geographically isolated area of Washington. as the Pierce County Nurse of the Year in 1987. She has
Dr. Babbo has a practice background in dialysis, also been a union representative, first with Washington
hemoperfusion, apheresis, and emergency, trauma nursing State Nurses Association, then with United Food
care. Dr. Babbo states she is humbled and honored and Commercial Workers (UFCW), negotiating and
to serve on the NCQAC for Washington State. “It is administering contracts for registered staff nurses in 22
an opportunity to serve and contribute to the nursing different hospitals. She also worked as a lobbyist for
profession and to promote excellent nursing care for the UFCW for 15 years.
citizens of Washington State.” Ms. Ness successfully helped introduce and pass a bill
making assault of a nurse or healthcare worker a class C
Edie Higby is a professional development and felony. Other legislative bills she helped pass include safe
communications specialist, and is also a new public lifting legislation, biohazard drugs legislation, and nurse
member of the Nursing staffing legislation.
Care Quality Assurance Sharon also worked with the Washington State
Commission. She, Department of Labor and Industries as a health care
along with all representative on the Washington Industrial Safety
commission members, and Health Act Advisory Committee, as well as the
are appointed by Governor’s Industrial Safety and Health Board, including
the governor of serving a few years as its president. She also worked on
Washington State. numerous occupational health regulations, such as blood
Ms. Higby attends borne pathogens, tuberculosis, and workplace violence.
public forum meetings In addition, Sharon served as chair of the first Safety and
and hearings to help Health Grant Program.
10 washington NURSING COMMISSION NEWSMs. Ness served on various boards in Pierce County, Catholic leadership. She is the chief nursing officer
including the Board of the American Red Cross, United at Providence St. Mary Medical Center in Walla
Way Board of Directors, and Workforce Development Walla. Yvonne has worked in pediatrics, medical,
Board. Sharon states, “I am honored to receive an surgical, psychiatric nursing and urgent care. She has
appointment to the Nursing Quality Care Commission. I more than 17 years’ experience in quality leadership,
will bring to the table my spirit for policy development, concentrating on patient safety, quality and risk
activism and advocacy for quality, safe patient care, management, as well as medical staff services and
and high standards of nursing, nursing care, and safe quality. She is a green belt in Six Sigma and a change
working conditions, which also serve to protect the facilitator for process improvement. Yvonne is married
patients we serve.” with two daughters and three grandchildren.
Ms. Strader states, “We are charged with the
Yvonne Strader health safety of our community and we will see vast
has been in nursing and fast changes in the years to come. The Nursing
for 30 years. She Commission looks at all aspects of nursing for
has a bachelor’s our future state of growth and needs of our state.
degree in nursing Nursing Commission work is the natural next step
and a bachelor of in my education and practice. I want to contribute
science degree in to the practice of nursing and its future state using
professional arts, as my experiences and skills in quality and process
well as a master’s improvement and leadership, upholding nursing to
degree in health the highest degree to support the workforce and
administration and those we serve.”
RN-BSN
Bachelor of Science
in Nursing
3 Affordable
l
3 Flexible
l
3 CCNE Accredited
l
People Centered, Quality Driven,
Service Focused Nurses
We are looking for applicants interested joining our team with an interest in
• Competitive tuition rates, financial Leadership and Staff Nursing. If these words describe the values you seek in a
aid/scholarships available. healthcare employer, we invite you to explore opportunities to join the team of
caregivers at Columbia Memorial Hospital (CMH).
• 1, 2, and 3-year completion plans
• Level IV trauma • Located in Astoria, Oregon,
with classes 1 or 2 days per week. • Full-service critical access hospital (listed as a top place to live
• Accredited by the Commission on • Proudly serving our community by numerous magazines & websites)
for over a century • Independent with
College Nursing Education (CCNE). • HFAP-accredited tremendous growth
• Planetree-designated, patient-centered in the last five years
Contact us today! healthcare organization
Call: 360-475-7748 or Call 503-338-4073 • www.columbiamemorial.org
Email: sriddle@olympic.edu Columbia Memorial Hospital • 2111 Exchange St. Astoria, OR 97103
washington NURSING COMMISSION NEWS 11By Christina Pryor, MLIS
Assistant Director and Community Health Education Coordinator
University of Washington
RING IN THE NEW YEAR
BY EARNING ONE FREE CNE CONTACT HOUR
BY ATTENDING A HEALWA WEBINAR!
HEALWA is once again offering a free online workshop about how to sign up for and use HEALWA,
and you can earn one free CNE contact hour just by attending. If you didn’t get a chance to attend in
2017, now is a great time to sign up through the HEALWA website.
Upcoming webinar schedule:
• Thursday January 11, 10-11 a.m. PST
• Thursday January 18, 7-8 p.m. PST
• Thursday February 1, 10-11 a.m. PST
• Thursday February 15, 7-8 p.m. PST
• Thursday March 8, 10-11 a.m. PST
• Thursday April 9, 10-11 a.m. PST
If you have any questions, please contact Kathryn Vela, MLIS, AHIP at 509-368-6557 or
kathryn.vela@wsu.edu or Christina Pryor, MLIS at 206-221-2452 or cnpryor@uw.edu.
This activity has been submitted to the Washington State Nurses Association Approver of
Continuing Nursing Education (A-CNE) for approval to award contact hours. The Washington
State Nurses Association Approver of Continuing Nursing Education (ACNE) is accredited as
an approver of continuing nursing education by the American Nurses Credentialing Center’s
Commission on Accreditation
12 washington NURSING COMMISSION NEWSEARN YOUR
DNP
Have a BSN or MSN? Seattle
Pacific University’s DNP program can
help further your career as a family or
adult/gerontology nurse practitioner
or clinical nurse specialist.
• Classes one day per week
• Full-time/part-time options
NURSES • Face-to-face instruction
We focus on robust academics
CARE FOR US and relationship-centered learning
to prepare you for excellence in
UW BOTHELL advanced practice nursing.
CARES FOR YOU Apply today! Visit spu.edu/dnp
or call 206-281-2888.
BECOME A CARING NURSE
• MASTER OF NURSING
• RN to BSN
Earn your MN in just 7 quarters
Earn your BSN in just 4 quarters
• Flexible options for the working nurse
• Hybrid course and program options
• One day per week schedule
• Multiple program locations
• Part-time option available
Summer, Fall, and Winter Admissions
Apply now for fall and winter!
RN to BSN LOCATIONS:
UW Bothell, Harborview Medical Center,
and Everett University Center
MN LOCATIONS:
UW Bothell and Providence Medical
Center, Pacific Campus
COME MEET US AT AN INFORMATION SESSION:
uwb.edu/nhs
uwbnhs@uw.edu
425.352.5376
washington NURSING COMMISSION NEWS 13By Lori Linenberger BA, CDP, NCAC II
Unbecoming a Nurse
Sometimes we may never know how substance use disorders can affect others. Paula Davies Scimeca
wrote a book called “Unbecoming a Nurse,” after losing her mother to an overdose in 2002. Her mother
was a nurse, and so is Paula Davies Scimeca. Her book highlights telltale signs there may be a chemical
dependency problem, and through her work providing presentations on the risk of substance abuse in
nursing, she developed The SHUNT self-survey for nurses.
The self-survey has 10 different components, which are
separated into two traits for each letter. The tool is a guide
to measure the possibility a nurse may have a substance
use problem. The tool is not diagnostic, and there is no
score that would reveal a measurable risk factor. Rather,
the SHUNT allows nurses to assess their own risk, based
on their answers.
The SHUNT Survey is as follows:
S – Social withdrawal or self-isolated behavior
S – Self-care behaviors beneath societal,
professional or the nurse’s own standard
H – History of chemical dependency in the nurse’s
immediate family
Scoring the survey is straightforward. Each positive
H – History of negative consequences related to the answer, or presence of a trait, is a score of one. There is no
nurse’s substance use. score if the trait does not apply. The higher the score, the
greater the risk factor. And though the tool is not intended
U – Untreated or unremitting emotional or to diagnose a substance use disorder, it can be a seen as
physical pain a more proactive tool to help the nurse develop lifestyle
changes to avoid peril.
U – Using medication for a reason it was not Early identification is key. It is important to address
intended or in a manner not recommended concerns before a substance abuse problem occurs. This
SHUNT self-survey was developed specifically for this
N – Nursing practice routinely in excess of 55 hours purpose. For nurses with risk factors for substance use
per week disorder, the survey should be completed at least annually
to identify, and address, any increased risk before a life
N – Nursing duties include frequent access to spirals out of control.
controlled substances. Washington Health Professional Services (WHPS)
provides support and monitoring services to nurses
T – Transitional period requiring major adjustments with substance use disorder. WHPS is available for
within the past year. consultation and CNE provided presentations. Please
contact us at 360-236-2880 or WHPS@doh.wa.gov to
T – Turmoil or tragedy with unresolved conflict. schedule a presentation for your staff.
14 washington NURSING COMMISSION NEWSwashington NURSING COMMISSION NEWS 15
By Nancy Lawton, MN, ARNP, FNP
BEING PART OF THE SOLUTION:
Preventing Opioid Overdose Deaths in Washington
Two people die of an opioid overdose nearly every day in Washington State. Though heroin and synthetic
fentanyl overdoses have increased in number, deaths from opiates prescribed by providers remain the
leading cause of unintentional overdose deaths. While the number of prescriptions for narcotics is decreasing
in Washington, the number of deaths has not.
Nurses have a role to play in reducing opioid deaths • Become waivered with the DEA to prescribe
in Washington. buprenorphine. https://aanp.inreachce.
• Enroll in and use the Prescription Monitoring com/Details/Information/714cb0a9-73b2-
Program (PMP) http://www.wapmp.org/ 4daf-8382-27cbdb70ef5a?ref=featured. One
practitioner/pharmacist/. As of July 2017 33 year after waivers became available, 137
percent of ARNPs were enrolled, leading Washington State ARNPs are now registered
physicians in percentage enrolled, but with the Drug Enforcement Administration
behind physician’s assistants and osteopathic as buprenorphine prescribers. Becoming
physicians. When seeing patients in clinical waivered requires 24 hours of continuing
practice, check the PMP before any and every education provided free through the
prescription for a controlled substance is American Association of Nurse Practitioners
written. If done every time for every patient, and the American Society of Addiction
we are not targeting any individual. Nurses Medicine. The training is free, but your
can be enrolled as delegates to simplify the time is not. Request additional time from
process in a clinic. your employer to complete the one-time
training. Use a low threshold for patients
16 washington NURSING COMMISSION NEWSto access buprenorphine. Even if a patient • Provide Naloxone, a short-term antidote for
continues using other drugs or alcohol, opioid overdose, to all patients receiving opioid
buprenorphine aids the patient in continued prescriptions, and to family members who
positive behavior change. Assist patients express concerns about relatives with substance
to find a source for substance use disorder use disorders. Be sure they know how and when
treatment with “no wrong door,” including to use naloxone. All Safeway and Albertson
primary care, behavioral health or chemical pharmacies in Washington now have naloxone
dependency treatment. Be aware of housing available directly from pharmacists. Pharmacies
and social services that can support a stock Narcan nasal spray. Patients can acquire it
patient’s efforts to become opioid-free. after a 15- to 20-minute pharmacy consultation.
A prescription permits insurance coverage. At
• Prevent opioid dependence to begin with increased risk of overdose are people who have
by careful opiate prescribing. Exposure to had a period of abstinence, such as someone
a first dose of opioids increases the risk of leaving rehabilitation or detox facility, jail,
recurrent use. Recognize that acute pain prison or after a hospitalization. Such people’s
can quickly be addressed with non-opiate tolerance will have decreased. If they resume
options. Chronic non-cancer pain requires opioid intake at the level they did before the
a multi-modality approach to learn means period of abstinence, they are at increased risk
of functioning and adapting using non- for overdose.
pharmacologic methods to maintain a higher
quality of life. • Support efforts for public and private insurers
to cover the costs of substance use disorder
• Follow the recommendations of the treatment; Medicare pays for some services and
Agency Medical Directors Guidelines not for others. Similarly, Apple Health programs
http://www.agencymeddirectors.wa.gov/ are inconsistent on what treatments for what
Files/2015AMDGOpioidGuideline.pdf for diagnoses are covered, exposing patients to
safe prescribing. If you are a prescriber, prohibitive costs.
refer to it. If you support prescribers,
make sure they are aware of and follow • Psychiatric ARNPs have a special role to play
these guidelines. The guidelines answer in providing cognitive behavioral therapy or
questions regarding challenging situations, dialectic behavioral therapy as a means of
including how to address the acute pain addressing chronic pain. The Washington
needs of a chronic pain sufferer. Support State Department of Labor and Industries now
alternatives to opioid prescribing for chronic pays ARNPs 100 percent of allowable charges
pain management including non-opiate for providing therapy to injured workers and
medications, exercise, yoga, counseling and assisting in their return to work.
complementary medicine.
• Learn where your nearest needle exchange
• Be aware of the new Health Care Authority program https://nasen.org/directory/wa/ is and
guidelines https://www.hca.wa.gov/billers- provide the information to patients.
providers/programs-and-services/opioids
restricting opioid prescribing to 18 tablets, a • Keep local and state legislators informed of
three-day supply for patients 18 and under, effective, evidence-based substance use disorder
and 42 tablets, a seven-day supply, for treatment options, and ask them to support and
patients over 18. fund these services in our communities
washington NURSING COMMISSION NEWS 17LICENSURE ACTIONS
The following is a list of stipulations to informal disposition taken between May 1, 2017, and September 30, 2017.
A stipulation is an informal disciplinary action where the licensee admits no wrongdoing but agrees to comply with certain terms.
Licensee Date of Informal Allegation
Action Action
Smith, Susan M., RN (RN00092786) 05/08/17 Surrender Violation of or failure to comply with licensing board order
Fernandez Gatley, Tiffany N., LPN (LP60273483) 05/30/17 Conditions Violation of federal or state statutes, regulations or rules
McArthur, Cheryl M., RN (RN00086912) 05/30/17 Conditions Alcohol and other substance abuse; Violation of federal or state statutes, regulations or rules
Esparza, Benito J., RN (RN60028013) 05/30/17 Conditions Alcohol and other substance abuse; Failure to cooperate with the disciplining authority
McGaffic, Heather J., RN (RN60641649) 06/28/17 Probation License suspension by a federal, state or local licensing authority
Trenter, Janet P., RN (RN00083413) 07/07/17 Surrender Diversion of controlled substance; Violation of federal or state statutes, regulations or rules
Chapin, Eva, LPN (LP00056547) 07/10/17 Probation License disciplinary action taken by a federal, state or local licensing authority
Jackson, Evelyn R., LPN (LP00058922) 08/08/17 Probation Negligence; Violation of federal or state statutes, regulations or rules
Cancio, Miner F., RN (RN00105265) 08/08/17 Probation Violation of federal or state statutes, regulations or rules
Willoughby, Amy M., RN (RN60528474) 08/31/17 Probation Violation of federal or state statutes, regulations or rules
Gulmire, Brian L., LPN (LP60712811) 09/13/17 Conditions License suspension by a federal, state or local licensing authority
Oliver, Andrew M., RN (RN60574652) 09/13/17 Conditions License suspension by a federal, state or local licensing authority
Davis, Rachel S., RN (RN00175615) 09/21/17 Conditions Fraud, deceit or material omission in obtaining license or credentials
The following is a list of formal licensure actions taken between May 1, 2017, and September 30, 2017. For more information, please use Provider Credential Search
(https://www.doh.wa.gov/LicensesPermitsandCertificates/ProviderCredentialSearch) or contact the Nursing Commission at 360-236-4703
Licensee Date of Formal Violation
Action Action
Fuller, Amanda M., RN (RN00148463) 05/01/17 Suspension License suspension by a federal, state or local licensing authority
Michels, Kevin J., RN (RN60615614) 05/05/17 Suspension License suspension by a federal, state or local licensing authority
Higginbotham, Shawn M., RN (RN60002592) 05/08/17 Conditions Alcohol and other substance abuse; Diversion of controlled substance
Hardy, Jessica L., RN (RN60596107) 05/08/17 Suspension License suspension by a federal, state or local licensing authority
Faye, Gwyneth F., RN (RN00148594) 05/11/17 Reinstatement Unprofessional conduct
Callicoat, Matthew M., RN (RN60028563) 05/18/17 Suspension Violation of or failure to comply with licensing board order
Lykins, Jodi K., RN (RN00137399) 05/22/17 Suspension Violation of or failure to comply with licensing board order
Domingos, Barbara J., RN (RN00149831) 05/22/17 Suspension Violation of federal or state statutes, regulations or rules
Feusi, David M., RN (RN60087223) 05/22/17 Suspension License suspension by a federal, state or local licensing authority
Kutrich, Dena R., RN (RN00152905) 05/30/17 Conditions Violation of federal or state statutes, regulations or rules
Staiger, Shawn W., RN (RN00103558) 06/06/17 Conditions Diversion of controlled substance; Narcotics violation or other violation of drug statutes; Violation
of federal or state statutes, regulations or rules
Hafurova, Tetyana H., RN (RN60152090) 06/07/17 Probation Negligence; Violation of federal or state statutes, regulations or rules
Funk, Victoria L., RN (RN60176992) 06/07/17 Reinstatement License suspension by a federal, state or local licensing authority
Hodo, Gina A., LPN (LP00040095) 06/08/17 Suspension Violation of or failure to comply with licensing board order
Elkin, Patricia J., RN (RN00121327) 06/16/17 Suspension Violation of or failure to comply with licensing board order
McShane, Deanna L., RN (RN60208635) 06/28/17 Conditions Alcohol and other substance abuse; Diversion of controlled substance; Violation of federal or
state statutes, regulations or rules
Kaiser, Brandi J., RN (RN60279828) 06/30/17 Suspension License suspension by a federal, state or local licensing authority
Welna, Theresa M., RN (RN00131021) 07/05/17 Reinstatement License disciplinary action taken by a federal, state or local licensing authority
Archer, Dawn D., RN (RN00164219) 07/05/17 Suspension Violation of federal or state statutes, regulations or rules
Millman, Barbara L., RN (RN60235507) 07/06/17 Suspension Diversion of controlled substance; Failure to cooperate with the disciplining authority
Kindy, Susan M., RN (RN60230982) 07/07/17 Conditions Alcohol and other substance abuse; Diversion of controlled substance; Violation of federal or
state statutes, regulations or rules
Byrd, Michael P., LPN (LP00049340) 07/10/17 Reinstatement Unprofessional conduct
Smith, Laura L., RN, ARNP (RN60696023, AP60696114) 07/17/17 Revocation Fraud in obtaining license or credentials; License suspension by a federal, state or local licensing
authority; Misrepresentation of credentials
Bui, Lynn M., RN (RN60271490) 07/17/17 Suspension Violation of or failure to comply with licensing board order
Snow, Ambrosia C., RN (RN60297094) 07/19/17 Reinstatement Violation of or failure to comply with licensing board order
Farmer, Janet G., LPN (LP60248740) 07/21/17 Suspension Violation of federal or state statutes, regulations or rules
Hull, Carissa D., RN (RN60060440) 07/21/17 Suspension Violation of federal or state statutes, regulations or rules
Small, Wallace D., Jr, RN (RN60334399) 07/21/17 Suspension Fraud – unspecified, License suspension by a federal, state or local licensing authority; Violation
of federal or state statutes, regulations or rules
18 washington NURSING COMMISSION NEWSLicensee Date of Formal Violation
Action Action
Cessor, Irene E., LPN (LP00043227) 07/28/17 Suspension Violation of or failure to comply with licensing board order
Tannler, Jonathan P., RN (RN60183136) 08/01/17 Suspension Violation of or failure to comply with licensing board order
Rishky, Amanda L., RN (RN00145820) 08/08/17 Conditions Diversion of controlled substance; Narcotics violation or other violation of drug statutes; Violation
of federal or state statutes, regulations or rules
Kopp, Lisa M., RN (RN00121611) 08/11/17 Suspension Alcohol and other substance abuse; Failure to cooperate with the disciplining authority; Violation
of federal or state statutes, regulations or rules
Joseph, Kenya E., RN (RN60098504) 08/16/17 Probation Violation of or failure to comply with licensing board order
Woolner, Alex M., LPN (LP60466910) 08/18/17 Revocation License disciplinary action taken by a federal, state or local licensing authority
Wayman, Mary Jane S., RN (RN60089672) 08/24/17 Suspension Violation of or failure to comply with licensing board order
Lindgren, Karin, RN, ARNP (RN00168324, AP30083868) 08/30/17 Reinstatement Unprofessional conduct
Carterette, Sara M., RN (RN00160764) 08/30/17 Conditions Alcohol and other substance abuse; License suspension by a federal, state or local licensing
authority; Violation of federal or state statutes, regulations or rules
Beachler, Melissa J., RN (RN60604083) 08/30/17 Reinstatement License suspension by a federal, state or local licensing authority
Sholes, Richard T., LPN (LP60342517) 09/12/17 Reinstatement Alcohol and other substance abuse; Diversion of controlled substance; Violation of federal or
state statutes, regulations or rules
Dunn, Mark R., RN (RN60585610) 09/12/17 Conditions License suspension by a federal, state or local licensing authority
Reyes, Iris, RNTP (RNTP60608998) 09/12/17 Reprimand Violation of or failure to comply with licensing board order; Negligence; Violation of federal or
state statutes, regulations or rules
Counts, Lynn M., RN (RN00123983) 09/13/17 Suspension License suspension by a federal, state or local licensing authority
Ruddell, Darrin L., RN (RN00133423) 09/13/17 Revocation Alcohol and other substance abuse; Diversion of controlled substance; Violation of federal or
state statutes, regulations or rules
Kindred-Joe, Ann L., LPN (LP60656116) 09/14/17 Licensure denied License suspension by a federal, state or local licensing authority
Becker, Jennifer A., RN (RN00157757) 09/14/17 Suspension Alcohol and other substance abuse; Violation of or failure to comply with licensing board order;
Violation of federal or state statutes, regulations or rules
Kim, Stacey E., RN (RN60523960) 09/19/17 Suspension Alcohol and other substance abuse; Diversion of controlled substance; Violation of federal or
state statutes, regulations or rules
Easter, Myra J., RN (RN60687119) 09/21/17 Suspension License suspension by a federal, state or local licensing authority
RN-TO-BSN PROGRAM
Earn your BACHELOR OF NURSING in 3 semesters!
• Combine on-site and online classes, part-time
or full-time study available
• On-site classes are 1 evening per week
www.stmartin.edu/nursing
nursing@stmartin.edu
washington NURSING COMMISSION NEWS 19By Tracie Drake,
Department of Health, Nursing Assistant Program Manager
NURSING ASSISTANTS
FEWER COMPLAINTS EQUAL LOWER FEES
In 2016 the Department of Health (department) had to raise nursing assistant application and renewal
fees to $65 and $70, respectively. During that time, I received many calls from nursing assistants who are
heavily burdened by this fee increase. The nursing assistant profession is an honorable calling that is often
overworked and underpaid.
The law requires that the cost of each profession per week. Each of these complaints is reviewed
be fully borne by the members of that individually by a case management team. Of
profession (RCW 43.70.250). Regulating the the 70 complaints received, about 16 cases are
nursing assistant profession requires numerous determined to require an investigation into the
Department of Health staff members. The allegations. Nursing assistant investigations
credentialing staff processes about 1,370 represent 48 percent of the total investigations
applications per month. The greatest expense for the department completes. This is because of the
regulating nursing assistants is processing the high number of credentialed nursing assistants
complaints received. According to mandatory and the mandatory reporting laws surrounding
reporting laws, all allegations of abuse or neglect the important work they do with vulnerable adults
must be disclosed. The Department of Health and children.
receives about 70 nursing assistant complaints
Below is a list of some of the more common complaints against nursing assistants received by the department.
Complaint Examples of Behavior
Communication Issues Yelling, speaking harshly, rude behavior, using profanity to or in the vicinity of clients/
patients.
Medication Errors Providing medication to the wrong client/patient, missing dosages, giving incorrect dosages.
Rough Being physically rough with client/patient when providing care.
Neglect Failure to timely feed, change brief, reposition, bathe, answer call light, etc., for client/
patient.
Elopement Resident wanders from facility or other location.
Sexual Abuse Inappropriate touching of patient or self in front of patient.
Abandonment Leaving patients alone in facility.
Diverting Medications Charting in MAR that medication was provided to patient when patient hasn’t received it,
claiming to have disposed of medication but not having second person verify disposal,
missing medication from client/patient private storage, missing medication from med carts.
Accepting Gifts Accepting money, food, meals, loans, etc. from client/patient.
Theft Theft of client/patient’s food, use of client/patient’s bank account or ATM card, theft of
items or money from client/patient’s personal belongings.
Abuse Locking patient/client in a room or not allowing mobility privileges; grabbing, hitting,
restraining, or pushing client/patient; prohibiting meals, TV, or call button; not allowing
visitors; threats of abuse; and taking pictures of client/patient.
Not Following Care Plan Inappropriate transfer, failing to provide two-person care, etc.
Drug or Alcohol Abuse Using drugs or alcohol inappropriately on or off the job.
Criminal Convictions Any criminal conviction may be grounds for discipline.
There are about 76,175 credentialed nursing assistants in Washington State. The vast majority of these will
never be disciplined for unprofessional conduct.
My hope in providing this information is to make nursing assistants aware of behavior that leads to
complaints. Ultimately fewer complaints will lead to lower application and renewal fees.
20 washington NURSING COMMISSION NEWSBy Shelly Rowden, Operations Manager
Washington State Department of Health Medical Marijuana Program
MEDICAL MARIJUANA AUTHORIZATION FORM
Starting January 1, 2018, all healthcare practitioners
will be required to use the newly designed 2018 Medical
Marijuana Authorization form. The new form is available
now and healthcare practitioners may order the Medical
Marijuana Authorization form tamper-resistant paper
from the same vendor they order prescription tamper-
resistant paper. For details and training resources, please
see the Medical Marijuana Authorization Form website.
(https://www.doh.wa.gov/YouandYourFamily/Marijuana/
MedicalMarijuana/AuthorizationForm)
We are allowing healthcare practitioners time to use up
their old tamper-resistant paper stock, but effective July
1, 2018, all authorizations will be required to be printed
on the tamper-resistant paper containing the Medical
Marijuana Authorization Form RCW 69.51A.030 seal.
If you have any questions, please contact the Medical
Marijuana program at 360-236-4819, option 1 or
medicalmarijuana@doh.wa.gov .
washington NURSING COMMISSION NEWS 21By: Christina Pryor, MLIS
Assistant Director and Community Health Education Coordinator
Exciting new evidence based resources added to
HEALWA
HEALWA: The On Call Library for Washington clinical and education information that improve
State Practitioners has some exciting news! patient care outcomes across Washington State.
HEALWA now has complete access to Signing up for HEALWA is easy! Just
ClinicalKey. Nurses across the state now have complete the following steps to receive a
access to a large library of Elsevier content HEALWA username and password:
including more than 1,000 eBooks, 680 eJournals, 1. Eligible users must ensure their contact
just under 3,000 drug monographs, and numerous information with the Department of Health
multimedia files including images and videos. In includes their current email address.
addition to this content, the ClinicalKey platform 2. Using a web browser, go to http://heal-wa.
includes First Consult Clinical Overviews, org/’s “Getting Started” webpage. Select the
which are scanable summaries that include option to create a University of Washington
evidence-based information, current guidelines, NetID. Then users enter their last name and
and the latest advances. credential number, and follow the on-screen
prompts to complete the registration process.
How to Access ClinicalKey 3. Then HEALWA emails the person a
To access the ClinicalKey platform, see the username and password, and the user may
HEALWA website at http://heal-wa.org/ and then start exploring the HEALWA resources.
use the “Log In” button in the orange box at the Once registered, HEALWA users have access
top of the screen. Once logged in you can get to from anywhere, anytime whether on a computer
ClinicalKey by using the “Databases” button or a mobile device. On healwa.org, use the “Log
in the blue bar running down the left side of the In” link located on the upper left corner of the
website. Use the letter “C” on the Databases screen.
webpage and select ClinicalKey from the list.
Once you are logged in and you have loaded Need Help or Have Questions about HEALWA
the ClinicalKey platform, you are ready to start Our goal at HEALWA is to help practitioners
researching. You can either type in what you across Washington State have affordable, anytime,
are looking for in the “Search” box located on online access to current, authoritative clinical
the screen or you can browse the collection by information and educational resources. If you
selecting the resource type directly below the need assistance with learning how to navigate
“Search” box. the resources or have questions about HEALWA,
If you have any questions about ClinicalKey contact the HEALWA librarian at 206-221-2452
or any of the HEALWA resources, contact the or by email at heal-wa@heal-wa.org .
HEALWA librarian at 206-221-2452 or by email You can also follow HEALWA on Facebook
at heal-wa@heal-wa.org. and Twitter.
Stay tuned for future HEALWA articles
Reminder about How to Sign Up for HEALWA featuring helpful tips and hints about how to get
HEALWA is here to provide support and access to the most information from your On Call Library.
22 washington NURSING COMMISSION NEWSwashington NURSING COMMISSION NEWS 23
By Hilarie Hauptman,
MSW, Kinship Program Manager, Aging and Long-Term Support Administration/Department of Social and Health Services; and
Kathy Moisio, PhD, RN, Nursing Commission, Nursing Education Consultant
GRANDPARENTS AND OTHER RELATIVES
RAISING CHILDREN:
HOW NURSES CAN SUPPORT THE UNIQUE NEEDS OF KINSHIP CARE FAMILIES
Drawing by Jenna (at age 8), winner of the
Generations United National T-Shirt Contest, May 2017.
Hundreds of grandparents raising grandchildren or United report (https://dl2.pushbulletusercontent.com/
“grandfamilies” in T-shirts bearing the powerful message qdCNUO2JMMZKzKRjyIlwbgjMtf39xkKa/16-Report-SOGF-
created by Jenna gathered at an inspirational “GrandRally” Final.pdf). Poverty, death, deployment, deportation, mental
(https://grandrally2017.org) on the lawn of the United States health issues, incarceration, and homelessness are other factors
Capitol last May. Jenna, winner of the Generations United precipitating kinship care, according to the American Academy
National T-Shirt Contest, is one of an estimated 40,000 of Pediatrics (AAP) (http://pediatrics.aappublications.org/
children in our state and 2.6 million children nationwide with content/pediatrics/early/2017/03/23/peds.2017-0099.full.pdf).
a grandparent or other relative raising them when their own Grandparents and other relatives acting as kinship
parents are unable to do so. These families are known as caregivers demonstrate tremendous resilience and
grandfamilies or kinship care families. commitment to providing a loving safety net and family
connection for these children, often at the cost of their
The Pathways to Kinship Care personal health and/or financial security. According to
Recent media attention has put a national spotlight the AAP, children in kinship care experience many of
on grandparents who have come to the rescue of the same adversities as children in traditional foster care.
their grandchildren because of the opioid epidemic. Surprisingly, for every child living with a relative in the
Substance abuse is the No. 1 reason for kinship formal foster care system, an estimated nine children are
care situations, according to a 2016 Generations living informally with relatives.
24 washington NURSING COMMISSION NEWSThe Unique Challenges of Kinship Care Kinship youth are, however, at lower risk than foster youth.
Washington survey data (https://www.dshs.wa.gov/ In-depth information on ACEs in kinship youth and the protective
sites/default/files/ALTSA/hcs/documents/kinship/HYS%20 effect of kinship care can be found in Generations United’s report:
2014%20Assoc%20with%20Kin%20and%20Homeless%20 State of Grandfamilies: 2017 (https://dl2.pushbulletusercontent.
-%20Preliminary%20Findings.pdf) are aligned with AAP com/uhDY7UgdGYnOod6G7VFkdKnuzE3yALmr/17-
findings. They show that – in association with trauma or InLovingArms-Grandfamilies.pdf).
adverse childhood experiences (ACEs) that often precede Washington data also seem to indicate alignment with AAP
the need for kinship care – kinship youth experience findings that kinship youth often lack access to primary care and
greater health risks than children living with their parents. dental care services. In addition, per the AAP, they are half as likely
Kinship youth show increased risk on multiple measures as children in non-kinship foster care to have an outpatient mental
in categories such as: mental health; general health; health evaluation, which is alarming given their frequent histories of
nutrition; physical activity; sexual behaviors; and ACEs and available depression and suicide attempt data (see Health
school achievement. Indicators table).
Health Risk Indicators: Kinship Youth vs. Youth Living With Parents in Washington*
Health Risk Indicator Kinship Youth Youth Living
with Parents
Obesity 16% 11%
Diagnosed with diabetes 6% 3%
No dentist check-up in past year 40% 20%
Missed school due to tooth ache in past year 13% 3%
Haven’t seen a doctor in past year 45% 35%
Smoked cigarettes in past year 16% 7%
Expressed depressive feeling past year 49% 34%
Attempted suicide in past year 18% 9%
*View Data Source
https://www.dshs.wa.gov/sites/default/files/ALTSA/hcs/documents/kinship/HYS%202014%20Assoc%20with%20
Kin%20and%20Homeless%20-%20Preliminary%20Findings.pdf
To complicate matters, accessing non-emergency health Due to these identified health risks and disparities, the AAP
services is challenging for a relative without court-ordered legal recently developed pediatric practice recommendations specific to
custody. Many relatives do not pursue custody or adoption because the unique care needs of kinship care families. (http://pediatrics.
of the cost, complexity, and emotionally grueling process that aappublications.org/content/pediatrics/early/2017/03/23/peds.2017-
can pit family members against one another – especially if there 0099.full.pdf)
is hope that the birth parent(s) will someday be able to raise their
children. To help in these circumstances, the Washington State Highlights of the AAP’s Pediatric Practice Recommendations:
Legislature passed a law more than a decade ago to enable relatives • Ask about caregiving arrangements during routine visits to
to fill out an affidavit for accessing mental, physical, and oral care. assure identification of kinship youth and comprehensive
The Kinship Caregiver’s Guide to Consenting to Health Care care coordination that meets their health needs.
(https://www.dshs.wa.gov/sites/default/files/SESA/publications/ • Learn about relevant resources and help caregivers access
documents/22-1120.pdf) is a helpful resource for this situation. support by providing or referring them to navigation
Kinship caregivers have needs and risks of their own. Per assistance. Note: A comprehensive Washington-based
the AAP, they tend to be significantly older and more likely than resource to have on hand is Grandparents and Relatives:
non-kin foster parents to report chronic health conditions or Do you know about the services and supports for you and
disabilities. Health conditions can be compounded by the stress the children in your care? (https://www.dshs.wa.gov/sites/
of the caregiving role – often unexpected and unplanned – and by default/files/SESA/publications/documents/22-1120.pdf)
economic stressors, given that the majority of kinship caregivers • Use a similar standard of care for kinship youth as for
represent single-parent households. children in foster care, as discussed in the AAP manual
washington NURSING COMMISSION NEWS 25You can also read
